Radiology, Vol 191, 69-74, Copyright © 1994 by Radiological Society of North America
Follow-up of benign hypoechoic peripheral zone lesions of the prostate gland: US characteristics and cancer prevalence
KT Fogarty, PH Arger, Y Shibutani, CF Nodine, JE Tomaszewski, BG Coleman, JE Jacobs, JE Langer and AJ Wein
Department of Radiology, University of Pennsylvania Medical Center, Philadelphia 19104.
PURPOSE: To evaluate the role of biopsy-proved benign peripheral zone
hypoechoic lesions of the prostate gland, ultrasonographic (US)
characteristics at follow-up, prostate-specific antigen (PSA) levels, and
digital rectal examination (DRE) in prediction of cancer risk. MATERIALS
AND METHODS: Retrospective analysis was performed for 105 consecutive
patients with 148 benign hypoechoic lesions discovered at transrectal US
(TRUS) and diagnosed with US-guided needle biopsy. At least one repeat TRUS
study was performed in each patient. RESULTS: Among the benign lesions, 72%
changed at follow-up TRUS, either disappearing or becoming smaller, less
hypoechoic, and more vague. Cancer developed in 13% of patients. In 93% of
patients in whom cancer developed, the appearance changed in the peripheral
zone at follow-up TRUS. In this patient population, the positive predictive
value for development of cancer was 16% with a changing TRUS appearance,
19% with an abnormal DRE result, and 27% with an elevated level of PSA;
only the latter was statistically significant. CONCLUSION: The PSA value,
alone or in combination with a changing TRUS appearance, is the best
indicator for development of cancer.
